Instruments that assess functioning in individuals with temporomandibular disorders and the International Classification of Functioning: systematic review

Mendes, Luana Maria Ramos; Barreto, Marina Carvalho Arruda; Castro, Shamyr Sulyvan

doi:10.5935/2595-0118.20210001

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REVIEW ARTICLE • BrJP 4 (1) • Jan-Mar 2021 • https://doi.org/10.5935/2595-0118.20210001 copy

Instruments that assess functioning in individuals with temporomandibular disorders and the International Classification of Functioning: systematic review

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

BACKGROUND AND OBJECTIVES:

The objective of this review was to study the tools used to measure functioning in individuals with temporomandibular disorders and verify its consistency with the model of the International Classification of Functioning (ICF), Disability and Health.

Systematic review performed in the databases Pubmed, PEDro, Scielo, Bireme, Web of Science, Cochrane, CINAHL, SPORTDiscus and Scopus. Published clinical trials from 2001 to 2019, in Portuguese, English and Spanish were included, with one of the outcomes being the evaluation of functioning of people with temporomandibular disorders. For the evaluation of the quality of the articles, the GRADE Checklist was used. The questionnaires were analyzed, and their questions coded according to the domains of the ICF. 425 articles were found and, after screening, 7 of them were included in this research. In these, 4 different instruments used to evaluate the functioning of people with temporomandibular disorders were found: Research Diagnostic Criteria for Temporomandibular Disorders, Mandibular Function Impairment Questionnaire, Pain Disability Index and the 11-point functional impairment scale. The frequency of ICF’s domains was: body functions (39.8%), body structure (22.8%), activity (17.7%), health condition (8.86%), personal factors (6.8%), participation (2.88), environmental factors (1.03%).

CONCLUSION:

The studies related to functioning in the temporomandibular disorder population is still scarce. Moreover, the instruments used fail to address the domains of the ICF in a homogeneous way, and some do not address the whole conceptual model, with an emphasis on gathering information about body functions and structures.

Keywords:
International Classification of Functioning; Disability and Health; Temporomandibular joint; Temporomandibular joint dysfunction syndrome

Authors	n	Objectives	Instruments	Methodological quality (PEDro scale)	Quality of evidence (GRADE)
Tatli et al.²2 Tatli U, Benlidayi ME, Ekren O, Salimov F. Comparison of the effectiveness of three different treatment methods for temporomandibular joint disc displacement without reduction. Int J Oral Maxillofac Surg. 2017;46(5):603-9.	120	Compare the effectiveness of treatment methods for unilateral displacement of the TMJ disk without reduction.	RDC/TMD- Axis II	7	Moderate
Calixtre et al.²²22 Calixtre LB, Oliveira AB, de Sena Rosa LR, Armijo-Olivo S, Visscher CM, Alburquerque-Sendín F. Effectiveness of mobilisation of the upper cervical region and craniocervical flexor training on orofacial pain, mandibular function and headache in women with TMD. A randomised, controlled trial. J Oral Rehabil. 2019;46(2):109-19.	61	Determine whether the upper cervical mobilization and training of craniocervical flexors decrease orofacial pain, increase mandibular function and pain thresholds through the pressure of masticatory muscles, decrease the impact of headache in women with TMD when compared with no intervention.	MFIQ	8	High
Shedden Mora et al.¹⁸18 Shedden Mora MC, Weber D, Neff A, Rief W. Biofeedback-based cognitive-behavioral treatment compared with occlusal splint for temporomandibular disorder: a randomized controlled trial. Clin J Pain. 2013;29(12):1057-65.	58	Evaluate the effectiveness of biofeedback-based cognitive-behavioral treatment versus dental treatment with occlusal plate.	PDI RDC/TMD	7	Moderate
Rodrigues et al.²³23 Rodrigues MDF, Rodrigues ML, Bueno KS, Aroca JP, Camilotti V, Busato MCA, et al. Effects of low-power laser auriculotherapy on the physical and emotional aspects in patients with temporomandibular disorders: a blind, randomized, controlled clinical trial. Complement Ther Med. 2019;42:340-6.	40	Evaluate the effects of low power laser application in auriculotherapy points on the physical and emotional aspects of individuals with TMD compared to the occlusal plate.	RDC/TMD	5	High
Vuckovic et al.²⁴24 Vuckovic NH, Williams LA, Schneider J, Ramirez M, Gullion CM. Long-term outcomes of shamanic treatment for temporomandibular joint disorders. Perm J. 2012;16(2):28-35.	23	Evaluate the feasibility and effectiveness of shamanic healing for individuals with TMD.	11-point functional impairment scale RDC/TMD	2	Low
Vuckovic et al.²⁵25 Vuckovic NH, Gullion CM, Williams LA, Ramirez M, Schneider J. Feasibility and short-term outcomes of a shamanic treatment for temporomandibular joint disorders. Altern Ther Health Med. 2007;13(6):18-29.	23	Evaluate the feasibility and safety of shamanic healing for individuals with TMD.	RDC/TMD - Axis II	2	Low
Wolfart et al.²⁶26 Wolfart S, Heydecke G, Luthardt RG, Marré B, Freesmeyer WB, Stark H, et al. Effects of prosthetic treatment for shortened dental arches on oral health-related quality of life, self-reports of pain and jaw disability: results from the pilot-phase of a randomized multicentre trial. J Oral Rehabil. 2005;32(11):815-22.	34	Evaluate the effect of two shortened dental arch treatment options on oral health related QL and RDC/TMD.	RDC/TMD	6	Low

Authors	Instruments	ICF's domains	n (%)
Shedden Mora et al.¹⁸18 Shedden Mora MC, Weber D, Neff A, Rief W. Biofeedback-based cognitive-behavioral treatment compared with occlusal splint for temporomandibular disorder: a randomized controlled trial. Clin J Pain. 2013;29(12):1057-65. Rodrigues et al.²³23 Rodrigues MDF, Rodrigues ML, Bueno KS, Aroca JP, Camilotti V, Busato MCA, et al. Effects of low-power laser auriculotherapy on the physical and emotional aspects in patients with temporomandibular disorders: a blind, randomized, controlled clinical trial. Complement Ther Med. 2019;42:340-6. Wolfart S et al.²⁶26 Wolfart S, Heydecke G, Luthardt RG, Marré B, Freesmeyer WB, Stark H, et al. Effects of prosthetic treatment for shortened dental arches on oral health-related quality of life, self-reports of pain and jaw disability: results from the pilot-phase of a randomized multicentre trial. J Oral Rehabil. 2005;32(11):815-22. Vuckovic et al.²⁴24 Vuckovic NH, Williams LA, Schneider J, Ramirez M, Gullion CM. Long-term outcomes of shamanic treatment for temporomandibular joint disorders. Perm J. 2012;16(2):28-35.	RDC/TMD	Health condition Function Body structure Activity Participation Personal factors Environmental factors Total	32(11.42) 111(39.65) 76(27.14) 33(11.79) 3(1.08) 21(7.50) 4(1.42) 280(100.00)
Tatli et al.²2 Tatli U, Benlidayi ME, Ekren O, Salimov F. Comparison of the effectiveness of three different treatment methods for temporomandibular joint disc displacement without reduction. Int J Oral Maxillofac Surg. 2017;46(5):603-9. Vuckovic et al.²⁵25 Vuckovic NH, Gullion CM, Williams LA, Ramirez M, Schneider J. Feasibility and short-term outcomes of a shamanic treatment for temporomandibular joint disorders. Altern Ther Health Med. 2007;13(6):18-29.	RDC/TMD- AXIS II	Health condition Function Body structure Activity Participation Personal factors Total	10(8.62) 58(50.00) 26(22.41) 11(9.49) 2(1.73) 9(7.75) 116(100.00)
Calixtre et al.²²22 Calixtre LB, Oliveira AB, de Sena Rosa LR, Armijo-Olivo S, Visscher CM, Alburquerque-Sendín F. Effectiveness of mobilisation of the upper cervical region and craniocervical flexor training on orofacial pain, mandibular function and headache in women with TMD. A randomised, controlled trial. J Oral Rehabil. 2019;46(2):109-19.	MFIQ	Health condition Function Body structure Activity Total	1(4.55) 10(45.45) 1(4.55) 10(45.45) 22(100.00)
Shedden Mora et al.¹⁸18 Shedden Mora MC, Weber D, Neff A, Rief W. Biofeedback-based cognitive-behavioral treatment compared with occlusal splint for temporomandibular disorder: a randomized controlled trial. Clin J Pain. 2013;29(12):1057-65.	PDI	Function Body structure Activity Participation Personal factors Environmental factors Total	13(20.31) 8(12.50) 30(46.88) 9(14.06) 3(4.68) 1(1.57) 64(100.00)
Vuckovic et al.²⁴24 Vuckovic NH, Williams LA, Schneider J, Ramirez M, Gullion CM. Long-term outcomes of shamanic treatment for temporomandibular joint disorders. Perm J. 2012;16(2):28-35.	11-point functional impairment scale	Function Activity Total	1(33.33) 2(66.67) 3(100.00)

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[1] Correspondence to: Rua Professor Costa Mendes, 1608, Bloco Didático, 5º A - Bairro Rodolfo Teófilo, 60430-149 Fortaleza, CE, Brasil. E-mail: castross@ufc.br

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Instruments that assess functioning in individuals with temporomandibular disorders and the International Classification of Functioning: systematic review

ABSTRACT

BACKGROUND AND OBJECTIVES:

CONTENTS:

CONCLUSION: